Nontuberculous mycobacterial disease in humans is clinically relevant infections. There are four types of nontuberculous mycobacterial disease. Most patients have lung disease, some of them have lymphatic disease, skin, bones and soft tissues disease or disseminated disease. Diagnosis of nontuberculous mycobacterial disease is based on microbiological, clinical and radiological data. Identification of mycobacteria is essential, as it influences the choice of antimicrobial agents. Treatment of nontuberculous mycobacterial disease is long lasting.
The purpose of the master thesis was to review the population that was diagnosed with nontuberculous mycobacteria at the Golnik University clinic between years 2009 and 2015 and analysis of the treatment of patients who were treated for it. The study included only the patients who were treated exclusively at the Golnik University clinic.
Nontuberculous mycobacterias were isolated from 420 patients. 42/420 patients were treated for nontuberculous mycobacterial disease – 36 patients had lung disease and 6 patients extrapulmonary disease. The risk factors that were frequently present in the treated patients were male sex (59.5%), average age 59.5 years, smoking (69.1% of patients) and the presence of at least one pulmonary diagnosis (54.8%). In patients with lung disease the most common symptoms at the beginning of the treatment were cough (88.8%), dyspnea (77.8%) and weight loss (55.5%), while in patients with extrapulmonary disease the typical symptom was a pain in the part of the body where infection had first occurred (50%). We identified 11 different pathogens as causes of nontuberculous mycobacterial disease, the most common of them being M. avium, M. kansasii, M. intracellulare and M. xenopi. The combination of ethambutol, rifampicin and clarithromycin was most often prescribed for the treatment. Changes in treatment occurred in 19/42 (45.2%) patients, most often due to ethambutol (11/19 patients). In 12/19 patients side effects were the reason to change the treatment.14/36 (38,9%) patients with lung disease and all 6 patients with extrapulmonary disease, 20/42 (47,6%) patients in total, successfully completed the treatment. Relapse occurred in 11/42 (26,2%) patients, especially in patients who completed the treatment prematurely (8/11 b 72,7%). 4/11 patients were treated again after relapse. On average, treatments lasted 351 days, successfully completed treatments 443 days, treatment failures 283 days and treatment failures because of side effects 185 days.